抗幽门螺杆菌治疗对脑梗死危险因素的影响

Impacts of treatment of Helicobacter pylori infection on the risk factors of cerebral infarction

目的探讨抗幽门螺杆菌(Helicobacter pyloru,HP)治疗对脑梗死常见危险因素的影响,明确HP与脑梗死的病原关系,为脑梗死的治疗和预防提供线索。方法将符合全国第四届脑血管病学术会议制定的诊断标准的87例HP-IgG阳性脑梗死患者随机分为治疗组(A)、对照组(B),给予常规的降纤、溶栓等治疗,A组增加奥美拉唑、克拉霉素和甲硝唑抗HP治疗,A、B两组于治疗前后分别进行CRP、FIB、血脂测定和神经功能缺损程度评定,并进行比较。结果CRP、FIB、TG治疗前后差值分别为：A组(-5．47±2．52)mg/L、(-1．34±0．94)g/L、(-1．704±1．73)mmol/L；B组(-4．24±2．35)mg/L、(-0．73±0．85)g/L、(-0．70±1．18)mmol/L；两组比较有显著性差异(P＜0．05)。结论抗HP治疗能有效降低TG、FIB和CRP的浓度,因此建议针对HP阳性的脑梗死患者应使用短期安全的抗生素治疗。

Objective To investigate the influence of antibiotic therapy of Helieobaeter pylori （HP） on risk factors of cerebral infarction such as plasma lipid and fibrinogen level in order to find out the risk factors influenced by HP infection and to provide basis for treatment and prevention of cerebral infarction. Methods The 87 patients with HP-IgG positivity were randomly allocated to treatment group （A group,44 cases）and no treatment group （i.e controlled group,B group,43 cases）. In addition to routine treatment, the treatment of A group consisted of omeprazole 20mg orally twice a day for 7 days, clarithromycin 500rag orally twice a day for 7 clays and metronidazole 400mg orally twice a day for 7 clays.The clinical history,physical examination and blood samples were performed for the following determinations：blood lipid, C-reactive protein （CRP） level,fibrinogen （FIB）level,HP-IgG titer before and after treatment.Results The difference between basal and final CRP, FIB and TG （△CRP, △FIB 和△TG） were （-5.47±2.52）mg/L,（-1.34±0.94）g/L, （-1.70±1.73）mmol/L in A group, and（-4.24±2.35）mg/L,（-0.73± 0.85）g/L, （-0.70±1.18） mmol/L in B group.The difference was significant in A group than in B group. Conclusion The eradication of HP can effectively decrease the levels of TG,FIB and CRP.Therefore,a short-term,safe,and effective course of antibiotic therapy would be a means in the treatment of HP-IgG positivity patients with cerebral infarction.